What is Good Posture?

By Teri Roberts

Posture is the position in which you hold your body upright against gravity while performing all activities during rest and movement. Your optimal posture is when the least amount of strain or stress is placed on ligaments and muscles during stationary and dynamic movements. Every person’s exact posture will be different, but the key components do not change. 

Good posture begins with the core. While in a standing, stationary position you should have three natural curves of the spine - an inward curve of your cervical spine (the back of your neck), an outward curve of the thoracic spine (upper back) and another inward curve of your lumbar spine (low back). Along with the three natural curves, while standing, you should have equal weight load through the left and right side of the body, creating a neutral pelvis. Any deviation of these curves or imbalanced weight bearing may cause poor posture patterns that ultimately will lead to injuries.

Correct posture is important to keep your “skeleton” in proper alignment, allowing proper use of your muscles. Correct posture will also help with abnormal wearing of surfaces that could result in arthritis. Proper posture decreases stress on ligaments and prevents fatigue of muscles, prevents strain and overuse, including backache and muscular pain, and is attributed to the appearance of being five to ten pounds lighter. Correct posture is not only important for activities of daily living (working, driving, cleaning, playing), but it is especially important during exercise. When watching athletes exercise, it is noticeable that correct posture leads to much better performance. The athlete that starts each activity with correct posture tends to have more endurance, more strength and fewer injuries. 

How do you determine your correct posture? 
At AZOPT, we utilize the “plumb line screen” to assess posture. The plumb line is a line hanging from the ceiling to the floor. While standing in place, the plumb line should pass through the center of ear, center of shoulder, center of hip and fall just in front of the ankle, as shown in the right image of Figure 1. The left image of Figure 1 demonstrates the neutral alignment with equal weight bearing on the left and right side.

While you do not need to string a line from the ceiling, you can stand in front of a mirror and look at your front and side view to determine if you demonstrate good standing posture. Alternatively, stand with your back against the wall, bringing your feet shoulder width apart and your heels about two inches away from the wall. Allow your head, shoulder blades and buttocks to touch the wall. You should only feel approximately one hand length of space between your back and the wall. If this is not the case, you most likely have poor posture. You can practice this posture at the wall many times during the day to retrain your standing posture. 

Throughout all exercise, it is important to demonstrate good posture. Keep your core engaged throughout the ranges of motion. An injury can occur when you forget to activate through the core and attempt to perform a heavy lift or try a novice movement. Correct posture should not be forgotten, regardless if the activity is standing, lying, or upside down. Our best advice is to maintain proper posture and use good form throughout your workouts.

Vestibular Issues in Physical Therapy

By: Jenna Buckwalter

Physical Therapy has increasingly become important in the treatment of vestibular issues, specifically Benign Paroxysmal Positional Vertigo. BPPV is caused by calcium crystals, called otoconia, that dislodge from their original position in the utricle, a structure in the ear, and travel to the semicircular canals. Here they disrupt the flow of fluid and cause dizziness or vertigo. Common symptoms of vertigo include dizziness, lightheadedness, unsteadiness, a loss of balance, blurred vision, nausea and/or vomiting. Furthermore, torsional movements of the eye called nystagmus may occur. These symptoms are usually brought on by position changes of the head such as lying down, bending over, nodding the head or shaking the head side to side. 

A physical therapist will determine the symptoms' origination point in your ear and canal systems by having you perform a series of movements. It is important for the physical therapist to perform this thorough examination of the patient, to determine if the reported signs and symptoms are from that of a vestibular origin, and not something more serious. Signs and symptoms that may suggest a more serious pathology include the 5 D’s: dizziness, dysarthria, dysphagia, diplopia or drop attacks. Additionally, different or sudden severe headaches, hearing loss, leg or arm weakness, numbness or tingling, and chest pain can all be signs of a more serious diagnosis. If physical therapy is unsuccessful in resolving a patient’s vertigo, or if the vertigo suddenly worsens with no explanation, further medical referral may be needed. 

Physical therapists may be recruited to treat other conditions with vestibular issues such as Meniere’s disease, MS, vestibular neuritis, labrinthitis, Parkinson’s disease and cervicogenic dizziness. One should always be informed of the patient’s constantly evolving status, and keep in mind the implications that these syndromes present to treatment. Although canal repositioning maneuvers are more than likely not implicated for these conditions, balance training and habituation exercises can be a very powerful tool to improve the quality of life for these patients. As it stands, BPPV is the most common vestibular issue treated by physical therapists. Please visit the following links for more about BPPV. 

http://www.tchain.com/otoneurology/disorders/bppv/bppv.html
http://www.mayoclinic.com/health/vertigo/DS00534/DSECTION=symptoms

Using Gymnastics in Adult Fitness Programs: The Key to Decreasing Vertigo

Many adult fitness programs are now utilizing gymnastic exercises in their classes to enhance our mobility and skills training. These gymnastic moves that we heavily favored as children can give us a very nauseated feeling as an adult. The dizziness, lightheadedness, and nausea can become extreme after performing forward or backward somersaults. Some individuals have these feelings with handstand holds or any other inverted positions.  Despite these challenges, it is important to perform these gymnastic skills. Let’s learn why we get so nauseous and what we can do to decrease that horrible feeling after flipping upside down.

Somersaults and other gymnastic moves are a great way to work on flexibility and strength. It places your body in positions that are not performed on a regular basis and allows for end range activity. Gymnastic skills also improve your body’s proprioception (how your body relates to other parts of your body) and body awareness (how you are able to move your body, or, in other words - coordination). Gymnastic moves encourage full body training that requires a “skill” component that will also allow you to track progress of your workouts.  Not to mention that gymnastics is pure fun!

Many adults become extremely dizzy when flipping upside down. This is completely normal and does not suggest a problem with sensory systems. The feeling of dizziness, more accurately vertigo, occurs when there is a conflict between signals sent to the brain by various balance systems of the body. Your brain receives input from four sensory systems of your body - vision, joints or proprioceptive system, skin pressure, and the vestibular system of the inner ear. 

The vestibular system is the primary sensory system in our body that contributes to balance and spatial orientation. The vestibular system comprises of two components - the semicircular canal system (for rotational movements) and the otoliths (for linear movement).  After a rotational movement (somersaults) or linear acceleration (swinging), the vestibular system sends signals to the brain structure of the eyes and the muscles. When you perform a novel activity such as a somersault, handstand or cartwheel, your body reacts to the movement, causing vertigo. The vertigo becomes even more complex when you take away the vision component while performing a backwards somersault. As kids we spent MUCH more time spinning, swinging, and in inverted positions. By increasing the time spent in inverted positions as adults, your sensory system will become more automatic, reacting faster with less less adverse feelings of vertigo.

You may ask, “How can I decrease the feeling of dizziness/vertigo during gymnastic drills?” The best way to improve is to practice. The increased repertoire of movement creates better sensory and neural connections, allowing for your system to react without the extreme feelings of vertigo. Additionally, remember to exhale when you roll, cartwheel or flip upside down and maintain a good level of hydration. Try not to close your eyes, allowing your visual system to assist with the vestibular system. 

If these tips do not eliminate the feeling of vertigo, you may still flip, spin, or hang upside down–just as long as the vertigo dissipates within a few minutes. If you have the feeling of vertigo and dizziness for hours after the workout you may want to call your physician.